Provider Demographics
NPI:1932212743
Name:CALIFANO, PAUL J (DPM)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:J
Last Name:CALIFANO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2369
Mailing Address - Street 2:4343 YAQUI PASS RD.
Mailing Address - City:BORREGO SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92004
Mailing Address - Country:US
Mailing Address - Phone:760-767-5051
Mailing Address - Fax:
Practice Address - Street 1:4343 YAQUI PASS RD.
Practice Address - Street 2:
Practice Address - City:BORREGO SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92004
Practice Address - Country:US
Practice Address - Phone:760-767-5051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE-1060213EP0504X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP0504XPodiatric Medicine & Surgery Service ProvidersPodiatristPublic Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT10751Medicare UPIN